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To become an insurance claims investigator, you don’t have to have formal qualifications if you have relevant experience within the insurance industry. However, increasingly a degree or professional industry training is desired by employers. Some roles may call for a private investigator or relevant licence for the State.

How to become an insurance claims investigator, what is an insurance claims investigator

How to become an insurance claims investigator

Do you love to investigate the facts, look at the evidence and work out who’s telling the truth? If this sounds like you, maybe you should learn how to become an insurance claims investigator. They spend their days playing detective and examining people’s claims to work out what actually happened.

What is an Insurance Claims Investigator?

An insurance claims investigator’s primary responsibility is to verify if the insurance claim that a client submits is valid and if so, how much the insurance company will pay to them. First of all, the insurance claims investigator needs to review the claim and any relevant documents to understand what degree of insurance coverage the person making the claim has. Then, depending on the situation, insurance claims investigators have several options to consider. They inspect the damage to property and make an assessment on the severity of it, calculating an estimate of the damages. They may interview or write to claimants, any witnesses, emergency services and medical professionals to determine events and whether there’ll be a claim settlement, further review or if the claim is denied. Or possibly examine police reports, damage to property, healthcare treatment and bills to decide up the degree of liability. Insurance claims investigators need to check every angle and perspective regarding the insurance claims to ensure that the claim request is not fraudulent. Once all details are verified and the claim is deemed valid, the claims investigator negotiates the financial settlement. If a settlement sum cannot be reached, the claims investigator recommends what legal options there are.

Skills & Interests:

An insurance claims investigator has a difficult role. Keen attention to detail is very important, whilst examining all the data gathered. You also need good interview and investigative skills coupled with effective communication to get the facts accurately from people. Once all the information is gathered, investigators must assess and decide whether the claim is valid or not. You need sound judgement and good decision-making skills for this part. Finally, once a claim is deemed valid, then the settlement must be calculated, therefore an aptitude for numbers and calculations is important for this role.

Hours & Conditions:

Working as an insurance claims investigator usually entails working standard hours from Monday to Friday on a full-time job. Often the role involves work outside of the office, inspecting property that was the subject of claims, such as damaged buildings and vehicles, or investigating and interviewing people involved in the claim. Driving is usually required as part of the role, to visit claimants and the locations of incidents, so a current driver’s license is often required for the job.

How to become an Insurance Claims Investigator: Qualifications

To become an insurance claims investigator, you don’t have to have formal qualifications if you have relevant experience within the insurance industry. However, increasingly a degree or professional industry training is desired by employers. Some roles may call for a private investigator or relevant licence for the State.

As the number of vehicles increases, the number of insurance claims and therefore investigators, is also likely to increase. Beyond the motoring sector, demand for insurance claims investigators in property and casualty insurance is expanding due to the number of natural disasters, such as floods and fires. These factors will be partially offset by automation where technology allows simple claims to be processed automatically. This means that fewer investigators are needed per claim, reducing the overall number of investigators.